Residential substance abuse treatment for pregnant and postpartum women and their children: treatment and policy implications

In FY 1993 and FY 1995, the federal government awarded 27 five-year grants that supported 35 residential treatment projects for substance-abusing pregnant and postpartum women and their children. These projects provided comprehensive culturally and gender-specific treatment. Preliminary aggregated data collected in a national cross-site evaluation of 24 of these projects are encouraging with respect to infant mortality and morbidity, treatment retention and completion rates, and behavioral changes in the participating mothers at six months postdischarge. Local evaluations reflect other benefits of treatment. Cost data are expected to demonstrate the efficiencies and benefits of these projects compared to no treatment.     

Evaluation of a tobacco prevention program on knowledge, attitudes, intention and behavior of tobacco use among fourth grade students--a preliminary study

This was a preliminary study to evaluate the effectiveness of a tobacco prevention program on knowledge, attitude, intention, and behavior of tobacco use among fourth-grade students in four north central Florida counties. The results suggest that the program was effective in improving students' knowledge, attitudes, and intention toward not using tobacco products. Data analysis showed that students in the education group had a greater improvement in knowledge than the comparison group. Students in the education group also improved their attitude and intention scores while the comparison group did not show any improvement. The results also indicated positive responses from the students. In addition, teachers also gave a very positive response to the program.     

Alternative solutions to the problem of selection bias in an analysis of federal residential drug treatment programs

In an evaluation of prison-based residential drug treatment programs, the authors use three different regression-based approaches to estimating treatment effects. Two of the approaches, the instrumental variable and the Heckman approach, attempt to minimize selection bias as an explanation for treatment outcomes. Estimates from these approaches are compared with estimates from a regression in which treatment is represented by a dummy variable. The article discusses the advantage of using more than one method to increase confidence in findings when possible selection bias is a concern. Three-year outcome data for 2,315 federal inmates are used in analyses where the authors separately examine criminal recidivism and relapse to drug use for men and women. Statistical tests lead the authors to conclude that treatment reduces criminal recidivism and relapse to drug use. The treatment effect was largest when the inference was based on the Heckman approach, somewhat smaller when based on the instrumental variable approach, and smallest when based on the traditional dummy variable approach. Treatment effects for females were not statistically significant.     

Vitamins, herbs, and supplements: tools of empowerment

1. Consumers who elect to use natural products are electing to do more than simply use a product. Their choice is an act of self-empowerment. 2. Education is necessary because these products most often are not being obtained in a professional, consultative setting but rather in chain discount department stores and supermarkets. 3. If consumers choose to address their health concerns using a natural-based treatment plan, consultation with a health care practitioner who shares this shift in perspective and who follows the literature is important. 4. A paradigm shift could be on the health care horizon, which when complete would make herbs and other natural products part of mainstream health care practice.     

Money as a Tool for Negotiating Separateness and Connectedness in the Therapeutic Relationship

It is nothing new to suggest that money has meaning. Whether or not one accepts Freud's (1908)linkage of money and feces, within our culture money is frequently seen as a direct pathway to feelings of power, agency, self-directedness, and personal satisfaction. Trachtman (1999) states, Money, psychologically speaking, is our projection onto coins, bills, bank accounts, and other financial instruments of our beliefs, hopes, and fears about how those things will affect who we are, what will happen to us, and how we will be treated by others or by ourselves...(Trachtman, 1999, p. 283). Yet this material is often unavailable for therapeutic exploration or understanding until it explodes into the therapy, often in unmanageable and countertherapeutic ways. This article will look at some of the ways in which money can be utilized to negotiate the ever-changing tensions between self and other, object and subject, intrapyschic and interpersonal, connection and separation that appear in every relationship. In particular, it will explore some ways that money issues within the therapeutic relationship can be turned into significant tools for understanding and working with anxieties about connection and separateness, both within and outside the therapeutic dyad.     

The program effect of batterer programs in three cities

Recent meta-analyses and experimental designs of batterer program evaluations suggest little or no program effect. This finding may be compromised by a variety of analytical issues. Instrumental variable analysis addresses some of these issues, especially the relationship of program dropout to batterer reassault. This method of analysis was, therefore, used to test for program effect in a multi-site evaluation. The sites were three well-established batterer programs using a gender-based, cognitive-behavioral approach (n = 640). Completing a batterer program reduced the likelihood of reassault by 44% to 64%, depending on the specification used. Completing a 3-month program appeared to be as effective as completing a 5 1/2- or 9-month program. This moderate effect is an accomplishment considering the problems associated with the program participants and the inconsistency in the criminal justice system at the research sites. The findings remain tentative because of weak instrumental variables for reassault, but do confirm the need for more complex analyses of program effect.     

Human resource issues in university health services

To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.     

Outbreaks of acute gastroenteritis associated with Norwalk-like viruses in campus settings

Norwalk-like viruses (NLVs) are transmitted by fecally contaminated food, water, fomites, and person-to-person contact. They are a leading cause of acute gastroenteritis epidemics in industrialized countries. NLV outbreaks are characterized by a 12- to 48-hour incubation period; nausea, vomiting, and diarrhea for 24 to 72 hours; and high secondary attack rates. NLV infections spread rapidly on college and university campuses because of close living quarters, shared bathrooms and common rooms, many food handlers, popular self-service salad bars in dining halls, and person-to-person contact through sports and recreational activities. The illness is generally mild and self-limited but an outbreak can strain the resources of campus health services and cause high absenteeism among both students and staff. Treatment is primarily through antiemetic medication and oral rehydration. Prevention and control of NLV outbreaks rests on promoting hand washing; enforcement of strict hygiene in all food preparation areas; and prompt, rigorous cleaning of potentially contaminated areas where someone has been ill.     

"It's not cricket": colonial legacies and contemporary inequalities

Cricket has been historically significant in defining notions of English national identity and continues to feature in debates over the inclusion/exclusion of immigrants in British society. British-African-Caribbean players are well represented in the English game but participation appears mediated by ethnic group membership. This contemporary pattern can only be understood when contextualized within the historical development of cricket in the Caribbean and, in particular, the struggles between whites and blacks and between the white elites. Over-representation in certain cricketing roles has been an ever-present feature of this negotiation; contemporary inequality is, therefore, largely a consequence of the legacy of British Imperialism.     

Best practice in couple relationship education

Relationship education is widely available to couples and is intended to reduce the prevalence of relationship distress, divorce, and the associated personal and social costs. To realize the potential benefits of couple relationship education, it needs to be evidence-based, offered in ways that attract couples at high-risk for relationship problems, and focused on factors that put couples at high-risk for future relationship problems.